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Regulatory: Malignant Hyperthermia - Coggle Diagram
Regulatory: Malignant Hyperthermia
Pathogenesis
A rare inherited muscle disorder (genetic predisposition)
Increases metabolism and muscle contractions cause hyperthermia
Hyperthermia then damages the CNS
The Ca disruption increases muscle contractions causing rigidity
The hypermetabolic condition disrupts calcium function (intracelluar hypercalcemia) in skeletal muscle cells
Triggering event occurs inducing a hypermetabolic state: stress; some medications like epinephrine, atropine, or digitalis; anesthetic agents like halothane, enflurane, isoflurane), or muscle relaxants like succinylcholine
Symptoms
Muscle rigidity (early sign)
Increase body temp (late sign)
Hypotension
Oliguria
Tachycardia
Hypercapnia
Decrease CO
Dysrhythmia
Rhabdomyolysis
Kidney failure and myoglobinuria
Risks
Stress
Trauma
Execise
Anesthesia (most common trigger)
Halogenated anesthetic or succinylcholine
Infection
Treatment
Cardiopulmonary support and monitoring
Muscle relaxant (dantrolene sodium)
Cool body temp and monitor core temp
Cool blanket
Ice pack
Discontinue anesthesia
Sodium bicarbinate for acidosis
Reg insulin and D50 for hyperkalemia
Labs/diagnostics
End-tidal CO2 monitoring
ABG
CMP
Myoglobin (urine and CBC)
Complications
Kidney failure
Metabolic acidosis
HF
CNS damage
Rhabdomyolysis
Myopathy
Cardiac arrest
Death
Multiple organ failure